研究以接受藥癮戒治的71名住院藥癮患者及68名患者家屬為研究對象, 其中依用藥種類將患者及家屬均分為海洛因組, 安非他命組及混合使用藥物組( 含強力膠成癮者 ). 研究目的探討三組患者面臨處理藥癮問題時的求助行為, 三組患者家屬的表露情緒 行為及拒絕患者程度.研究工具為研究者自擬 "藥癮患者接受戒治模式前求助行為問卷( The Help- Seeking Behaviors Questionnaire of Drug Addicts; HSBQ)", "中國人五分鐘演說樣本評估手冊 (Chinese Five Minutes Speech Sample; CFMSS)", "拒絕患者程度量表 (Patient Rejection Scale; PRS)". 以訪談及錄音的方式收集資料. 研究資料以描述性統計, 卡方檢定, 單因子變異數分析, 積差相關, t 值檢定進行分析.得重要研究結果為: 一. 71名藥癮患者中, 男性佔87.3%,平均年齡 26.66歲, 平均教育年數9.95年, 過半數未婚及有宗教信仰. 其中海洛因組佔32.4%,安非他命組佔28.2%,混合使用組佔39.4%.患者在入院前即已被警方逮補者佔57.7%; 42.3%的患者並沒有固定經濟來源; 50.7% 的患者入院前並無工作. 二. 患者在住院期間中途停止治療率達25.4%,原因以再度使用藥物居多, 三組患者在停止治療的情形有顯著差異 (X2=11.78, p<.01); 住院期間有 29.6%的患者外宿外出後再度使用藥物. 三. 患者的戒癮動機多是為了外在因素而來求戒, 選擇到凱旋醫院戒治的動機以 "為了戒癮證明書為最多". 四. 研究對象所經驗的藥癮處理方式以使用藥物治療的生理戒斷為主, 在採取求助行為時, 以隱密性為主要考慮. 五. 90.1% 的患者有過戒癮經驗, 戒癮經驗中以 "家中自戒" 的方式為最多, 其次是 "藥房",第三是 "戒毒中心"家人及朋友是患者最先求助的對象. 六. 同一時間有 65.6% 的人只使用一種求助方式, 每人平均使用過兩種以上的求助方式. 七. 67.2% 的患者第一次面齡處理藥癮問題時, 會先採用自我服藥及診斷的自我療法. 八. 藥癮患者求助經驗多以西醫為主. 九. 與患者第一次求助行為最有相關的因素, 以卡方檢定及積差相關分析, 結果顯示與患者沒有固定經濟來源, 用藥年數較久, 有非藥物犯罪紀錄, 低教育程度, 及曾接受戒治次數有關. 十. 68名患者家屬中, 女性佔60.3%,父母親佔 70.6%, 平均年齡46.51歲,教育程度多為小學畢業或肄業. 其中海洛因組佔30.9%,安非他命組佔25.0%,混合使用組佔44.1%.十一. 根據 CFMSS的評估結果, 患者家屬呈現高表露情緒行為(HEE) 者有45人(66.2%);海洛因組, 安非他命組及混合使用組三組家屬中, 混合使用組出現較多" 自我犧牲 "指標及HEE.十二. 從家屬的演說敘述中顯示, 家屬對患者似乎呈現出一種愛恨交加的情緒. 十三. 與家屬HEE 最有相關的因素, 以卡方檢定及積差相關分析顯示, 除患者用藥種類之外, 還與家屬低教育程度, 及患者首次用藥年齡越輕有統計上相關. 十四. 家屬對患者的拒絕程度平均在中等程度以下; 家屬對患者存在著矛盾的情緒. 十五. 與家屬拒絕患者程度最有相關的因素以積差相關分析顯示, 家屬越呈現HEE 者, 其拒絕患者程度越明顯. 建議: 根據本研究結果, 建議戒治場所應 "醫療化",多增加社會及心理方面的介入, 並包括家族治療, 對藥癮患者應增加患者的戒治動機; 同時為避免處方藥物的濫用, 應加強市面上藥房的管制, 及患者對正確用藥的衛生教育.

The purpose of this study was to examine the help-seeking behaviors of the drug addicts, and the expressed emotion, rejecting patient's attitudeof the caregivers of the drug addicts. Paying particular attention to the relations between what kind of drug(heroin, amphetamine and mix)that addictsused and the study variables. DESIGN AND METHODS: The sample (71 patients, 68 caregivers) was selected fromthe Kai-Shan Hospital Drug Addiction Unite between July 1996 to January 1997.The measurement instruments included HSBQ(The Help-Seeking Behaviors Questionnaire); CFMSS(Chinese Five Minutes Speech Sample); PRS(Patient Rejection Scale) and clinical record. The face to face interview and tape recording were used. The data analysis included chi-square test, ANOVA test, t-test and Pearson correlation. RESULTS: 1.The addcits were 62 males and 9 females, the average age of this group was 26.66 years old, and the drop-out rate of the patients was 25.4%. They were divided into three groups: heroin(32.4%), amphetamine(28.2%), and mix(39.4%). 2.Generally the addicts were in jobless, under arrested, and relapse condition. 3.The cognition of drug addiction of the addicts still halts in euphoria stage. 4.The major motivation of quitting addiction of the patients was to deal with the problems that induced by drug addiction. And the reason of quitting drug in hospital was "for the quitting drug addiction certificate". 5.The top four resources that addicts used were their families and friends, quitting in home by themselves, buying prescription drugs from drug stores, seeking for treatment in the quitting addiciton center.6.Mostly they used one help-seeking behavior in one time, self-medication first, and western medical. 7.Patients' income, level of education, criminal record, years of using drug, and quitting times were significantly related to the use of various help-seeking resources. 8.The caregivers of the addicts were 27 males and 41 females, the average age of them was 46.51 years old. They were divided into three groups: heroin(30.9%), amphetamine(25.0%), and mix (44.1%). 9.66.2% of the caregivers were classfied as high expressed emotion (HEE). The HEE rate was more in lower level of education than higher level of education group, in lower using drug age of addicts group, also in using mix drugs group of addicts. 10.The characteristic of the interaction of patients and caregivers was interdependence, boundary unclear, and revealed ambivalence emotion. 11.The level of rejecting patients of the caregivers was under medium level, but existed self-contradictory emotion toward patients. 12.The caregivers' attitude of rejecting patients wasonly related related to theirs high expressed emotion(HEE). And the more HEEthey have, the higher level of rejecting addicts. CONCLUSION AND SUGGESTIONS: The results of this study indicate that to reestablished the relationship between medical and legal, and to develop a biopsychosocial program (especially including family therapy) for the drug addicts, and to restrict the use of prescription drugs in drug stores, and to enhance drug health education are important.